Individual
MICHELE A IVANIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
6730 W 121ST ST, OVERLAND PARK, KS 66209
(913) 307-0044
Mailing address
6720 W 121ST ST, OVERLAND PARK, KS 66209-2002
(913) 307-0044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209017010
IL
363L00000X
Nurse Practitioner
Primary
53-78722-122
KS
Other
Enumeration date
03/06/2018
Last updated
09/22/2019
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